This is the competing renewal application for a T32 program that has been supporting research training in the Duke GI Division since 1965. The goal of the program remains to train outstanding individuals with doctoral degrees (MD, PhD, or MD/PhD) to conduct independent investigation relevant to the basic mechanisms, treatment, and outcomes of gastrointestinal, pancreatic, and liver diseases. Since funding was last renewed in 2006, the program has graduated 4 MD researchers (2 men/2 women), all of whom are now full members of the Duke GI Division faculty. Each has already secured further research career development funding from NIH and/or foundations. Another 3 MD trainees (including an Asian American woman) will soon be completing T32 training support. All of these will also remain at Duke to continue training, and two of the three recently won research grants to support their continued career development. Another two MDs (including a woman) will enter the T32 program in July 2010. Two other MD trainees, including an African American woman, have been selected for enrollment in July 2011. During this renewal, the training program has been re-organized into 3 Tracks to more clearly delineate the training programs and faculty in our three areas of research excellence: basic science (Track I), clinical research (Track II) and outcomes research (Track III). It provides a unique opportunity for intensive training in techniques, concepts, principles, and attitudes which will permit our trainees to pursue a career in research into the basic mechanisms, treatments, and outcomes of GI/liver diseases. Physicians and Ph.D.s trained by our program will be optimally prepared to play key roles in translational research aimed at: 1) elucidating disease mechanisms using state of the art molecular approaches; 2) gaining new clinical insights into the diagnosis and natural history of GI/liver diseases; 3) development of new treatment approaches for GI and liver disorders; and 4) refining clinician practice and health delivery systems to optimize the positive impacts of new knowledge/treatments of GI and liver diseases. Our program's recent track record attests to its success at achieving these mile stones that are pre-requisites for advancing prevention, treatment, and cure of GI/liver diseases.